Reforming the Westminster Model of Agency Governance: Britain and Ireland After the Crisis

Abstract

Conventional understandings of what the Westminster model implies anticipate reliance on a top-down, hierarchical approach to budgetary accountability, reinforced by a postNew Public Management emphasis on recentralizing administrative capacity. This article, based on a comparative analysis of the experiences of Britain and Ireland, argues that the Westminster model of bureaucratic control and oversight itself has been evolving, hastened in large part due to the global financial crisis. Governments have gained stronger controls over the structures and practices of agencies, but agencies are also key players in securing better governance outcomes. The implication is that the crisis has not seen a return to the archetypal command-and-control model, nor a wholly new implementation of negotiated European-type practices, but rather a new accountability balance between elements of the Westminster system itself that have not previously been well understood.

The quest for a better performing health system: Public expertise and corporate management recipes in France

“…Hence, the deployment of activity indicators does not necessarily imply their appropriation by the profession (Gomez et al, 2012) and the resurgence of the technocratic ideology (Habermas, ) does not always served the public interest (De Marchi, Lucertini, & Tsoukiàs, ; Grant, ) in traditional (e.g., health) or new areas (e.g., the environment) where inherent incommensurability exists (Hwang, ). The government's struggle to figure out how to make a good use comprehensive datasets highlights two critical elements of accountability (Dommett et al, ): control, which refers to “the ability of principals to impose rules or demand specific actions and accounts from actors” and proved attainable and “oversight,” which refers to “the ability of the principals to survey the work of actors under their control.” Despite a National Health Agency (i.e., an agency of health agencies; Courrèges & Lopez, ) to ensure coordination among Regional Health Agencies, health authorities operate without sufficient direction.…”

“…The 2009 HPST bill (“Hôpital, Patients, Santé and Territoire”) reconcentrated the decision‐making process within the larger Regional Health Authorities (RHA) or Agences Régional de Santé (i.e., the executive arm of the Ministry of Health) that now regroups smaller regional public health agencies that used to be independent. Doing so, the bill “re‐emphasized the supremacy and legitimacy of ministers and departments over agencies” (Dommett, MacCarthaigh & Hardiman, ). Moreover, powers of regional Prefects (the préfet ) were extended.…”

Technocratic recentralization in the French health care system: A critical evaluation

“…They became responsible for the planning and allocation of resources to local hospitals in lieu of the prefect, coordinating, reviewing, and evaluating their activity (Article L6115‐1 CPS). The 2009 HPST Act recentralized the decision‐making process further by regrouping the regional hospital agencies within the larger Regional Health Agencies (RHA) or Agences Régional de Santé , ie, the executive arm of the central government (their director is appointed by the Ministry of Health), and doing so “re‐emphasized the supremacy and legitimacy of ministers and departments over agencies.”…”

“…These setbacks highlight two critical elements of accountability: control that refers to “the ability of principals to impose rules or demand specific actions and accounts from actors” and proved attainable and “oversight” that refers to “the ability of the principals to survey the work of actors under their control” (eg, physicians), which is more difficult to achieve. Despite a National Health Agency (ie, an agency of health agencies), to ensure greater accountability and coordination among agencies, French health authorities operate without sufficient coordination and opacity remains, for instance, in DRG calculation .…”

Swimming on Land: Some Suggestions for Today’s Public Administration

“…On the one hand, decentralization, which figured prominently in the NPM reforms, aimed at bringing services closer to the target populations and dismantling the complexities and inefficiency of the hierarchical decisionmaking process. On the other hand, it fragmented organizational structures and created inequality between different users, resulting in the post-NPM reforms that called for integration and unification (Christensen et al 2014;Dunleavy et al 2006;Dommett et al 2016;Rhodes 2000). The pros and cons of these contradictory processes are part of a long-standing dialogue aimed at balancing the two (Metcalfe and Richards 1987: 78-79).…”